高频震荡通气在重症胎粪吸入综合征中的应用

Effects of high frequency oscillatory ventilation in the newborn meconium aspiration syndrome

目的 探讨高频振荡通气在新生儿重症胎粪吸入综合征(MAS)中的早期应用.方法 21例重症MAS新生儿经常规机械通气(CMV)治疗失败后改为高频振荡通气(HFOV)治疗,治疗过程中监测经皮测氧饱和度、动脉血气及氧合指数、动脉肺泡氧分压(a/A)等.结果 21例患儿用HFOV治疗2 h后吸入氧浓度(FiO2)明显下调,a/A PaO2比值升高,差异有统计学意义(P<0.05);至6 h后差异有统计学意义(P<0.01),且未出现肺气压伤、支气管肺发育不良等后遗症.结论 重症MAS用CMV无效后改用HFOV可获得显著疗效.

Objective To evaluate the effects of high frequency oscillatory ventilation (HFOV)in the newborn meconium aspiration syndrome. Methods Twenty -one newborns with meconium aspiration syndrome performed the HFOV after failure of conventional mechanical ventilation(CMV). The O2 saturation,the ratio of a/A PaO2, arterial blood gas and oxygenation index were monitored in the course of HFOV. Results The FiO2 reduced significantly after 2 hours HFOV, the ratio of a/A PaO2 increased significantly(P <0. 05) ,and the change was high significantly after 6 hours HFOV(P <0. 01). There was no the adverse effect of pulmonary barotraumas and bronchopulmonary dysplasia. Conclusions HFOV is an effective method for neonatal infants with severe MAS after failure of CMV.